Employee Reference Check Form

Candidate Name(Required)

First Name Last Name

Position Applied For(Required)

Referee Name(Required)

Title(Required)

Company(Required)

Date(Required)

Are/Were you their direct boss, and how long did they work for the company?(Required)

What was your overall impression of them?(Required)

What were their duties and how competent were they in carrying them out?(Required)

Were they suitable in this role?(Required)

Handling of work objectives/ pressure/ deadlines? Any examples?(Required)

Self-motivation/ commitment/ loyal to the company? Any examples?(Required)

What was his/ her general attitude (ie. Confident; sensible; lazy; clever)?(Required)

Good attitude, fits in well?(Required)

Check 3 criteria from the job role (eg: How was their customer service?, How skilled are they at diagnostic work?, How often do they run overtime on jobs?)(Required)

How did he/she get on with management and other staff? Any examples?(Required)

What did you see as his/her particular strengths? Any examples?(Required)

What are the areas he/she could develop further (eg. Time management; technical skills)?(Required)

Can you confirm his/her salary (as quoted $ pa/phr)?(Required)

Can you verify you are not aware of any acts of dishonesty, fraud or other illegal activity with respect to the candidate?(Required)

Have there been any breaches of Company Policies? (Includes computer, phones & Internet)(Required)

Hypothetically, would you re-employ this person?(Required)

Are you aware of any health or other issues that may affect the candidate’s work performance?(Required)

Any other comments (particular relevant to the position applied for)?(Required)

Referee’s credentials verified by the referee’s organisation. Yes/No(Required)

Referee verified by (name & position):(Required)

Team member who has taken this reference:(Required)

EMPLOYEE REFERENCE CHECK

Employee Reference Check Form

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